Bell's palsy: Difference between revisions
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==Diagnosis== | ==Diagnosis== | ||
[[Bell's palsy history and symptoms|History and Symptoms]] | [[Bell's palsy physical examination|Physical Examination]] | [[Bell's palsy laboratory findings|Laboratory Findings]] | [[Bell's palsy CT|CT]] | [[Bell's palsy MRI|MRI]] | [[Bell's palsy other diagnostic studies|Other Diagnostic Studies]] | |||
==Treatment== | ==Treatment== | ||
[[Bell's palsy medical therapy|Medical Therapy]] | [[Bell's palsy medical therapy|Medical Therapy]] | ||
== Risk Stratification and Prognosis== | == Risk Stratification and Prognosis== | ||
Revision as of 14:03, 22 August 2012
| Bell's palsy | |
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| ICD-10 | G51.0 |
| ICD-9 | 351.0 |
| DiseasesDB | 1303 |
| MedlinePlus | 000773 |
| MeSH | D020330 |
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Bell's palsy Microchapters |
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Diagnosis |
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Treatment |
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Case Studies |
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Bell's palsy On the Web |
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American Roentgen Ray Society Images of Bell's palsy |
For patient information click here
Editor-in-Chief: Gilbert Abou Dagher, M.D.
Overview
Historical Perspective
Classification
Pathophysiology
Causes
Differentiating Bell's palsy from other Diseases
Epidemiology and Demographics
Natural History, Complications and Prognosis
Diagnosis
History and Symptoms | Physical Examination | Laboratory Findings | CT | MRI | Other Diagnostic Studies
Treatment
Risk Stratification and Prognosis
- The House-Brackmann grading system was devised both as a clinical indicator of severity and also an objective record of progress.
- Clinically incomplete lesions tend to recover.
- The natural history without treatment was described in a study of 1011 patients in 1982:
- 67% had incomplete paralysis, with 94% rate of return to normal function
- 33% had complete paralysis, with 60% rate of return to normal function
- By 3 weeks, 71% had complete recovery, 13% had slight sequelae , and 16% had residual weakness
- Herpes zoster is associated with more severe paresis and worse prognosis compared with "idiopathic" Bell's palsy.
- There is a favorable prognosis if some recovery is seen within the first 21 days of onset.
- In severe lesions that recover, the outgrowth of new axons from the injury site may be disorganized and misdirected.
- On blinking there is twitching of the angle of the mouth, and on smiling the eye may close or wink.
- With misdirected autonomic fibers, a salivary stimulus may result in excess lacrimation, the syndrome of "crocodile tears."
- Recurrent attacks of on either the ipsilateral or contralateral side have been observed in 7 to 15% of patients.
References
Additional Resources
- Sullivan FM, Swan IRC, Donnan PT, et al. Early treatment with prednisolone or acyclovir in Bell's palsy. N Engl J Med 2007;357:1598-1607.
- "The Merck Manual"
- New England Journal of Medicine, Sept. 2004
- Lambert, Michael. (2007-03-05) "Bell's Palsy." (Website.) Emedicine. Retrieved on 2007-09-27.
External links
- managment and treatment of facial paralysis
- Bell's Palsy Information Site, has a FAQ
- Bell's Palsy and Pregnancy
- Bell's Palsy Patient Info - Neurology Channel
- Living with Facial Palsy, a site for parents of children with Facial Palsy
- Links to pictures of Bells palsy (Hardin MD/Univ of Iowa)
- Bell's Palsy Association
Template:PNS diseases of the nervous system
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